Temperamental resistance to control increases the association between sleep problems and externalizing behavior development.
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This study examined the moderating effects of temperamental resistance to control on the link between development of sleep problems and development of externalizing behaviors over a 5-year period. Resistance to control was assessed with mothers' retrospective reports of temperament in infancy, provided when children were 5 years of age. Sleep problems were assessed with mother reports on an annual basis from age 5 to age 9. Externalizing behaviors were assessed with teacher reports on an annual basis from age 5 to age 9. A cross-domain latent growth curve model indicated that sleep problem trajectories were positively associated with externalizing behavior trajectories only for children high in resistance to control. In addition, resistance to control was positively associated with initial (age 5) sleep problems and initial (age 5) externalizing behaviors. The authors speculate that the development of sleep problems promotes the development of behavior problems for resistant children, whose self-regulatory abilities are especially tenuous. Implications for prevention and treatment of conduct problems are considered. (+info)
Animal defense strategies and anxiety disorders.
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Anxiety disorders are classified according to symptoms, time course and therapeutic response. Concurrently, the experimental analysis of defensive behavior has identified three strategies of defense that are shared by different animal species, triggered by situations of potential, distal and proximal predatory threat, respectively. The first one consists of cautious exploration of the environment for risk assessment. The associated emotion is supposed to be anxiety and its pathology, Generalized Anxiety Disorder. The second is manifested by oriented escape or by behavioral inhibition, being related to normal fear and to Specific Phobias, as disorders. The third consists of disorganized flight or complete immobility, associated to dread and Panic Disorder. Among conspecific interactions lies a forth defense strategy, submission, that has been related to normal social anxiety (shyness) and to Social Anxiety Disorder. In turn, Posttraumatic Stress Disorder and Obsessive-Compulsive Disorder do not seem to be directly related to innate defense reactions. Such evolutionary approach offers a reliable theoretical framework for the study of the biological determinants of anxiety disorders, and a sound basis for psychiatric classification. (+info)
Burnout in intensive care unit.
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AIM: The aim of this paper was to study in intensive care unit (ICU) the impact of variable ''professional role'' and ''gender'' on the defence mechanisms, on the troubles of mood and on the markers of the burnout syndrome, and to study the correlation between specific defence mechanisms or specific troubles of mood and the onset of burnout syndrome. METHODS: An observational study by administration of psychometric tests was carried out. Twenty-five nurses and 25 doctors working in two differents ICU of the Azienda Ospedaliera-Universitaria Pisana were enrolled. Three psychometric tests concerning the defence mechanisms (Defense Mechanism Inventory), the troubles of mood (Profile of Moods States) and the burnout syndrome (Maslach Burnout Inventory) were administered and the three tests were analysed to study the features of each person enrolled. RESULTS: The study shows the presence within doctors of two dimensions of burnout syndrome (emotional exhaustion in women and depersonalization in men) much greater than nurses. The doctors show the presence of defence mechanism as overturning, aggressiveness and rationalization, and troubles of mood as depression-despondency and aggressiveness-anger. Compared to men, women show turning to one self as defence mechanisms, whereas the men show aggressiveness-anger as trouble of mood. The women doctors show depression-disheartement as trouble of mood, the men doctors show tension-anxiety. We showed a correlation between tiredness-indolence, depression-disheartement and onset of emotional exhaustion, as a correlation between aggressiveness, aggressiveness-anger in man and oncet of depersonalization. Finally we correlated the absence of tension-anxiety as trouble of mood and overturning as defence mechanism with a good personal accomplishment at work. CONCLUSION: The burnout syndrome is present in health-care workers in ICU and it is significantly affected by operating role and gender. We must be aware of this phenomenon in order to study it and to reduce it. (+info)
Can the components of a cognitive model predict the severity of generalized anxiety disorder?
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Over the past decade, a number of well-controlled studies have supported the validity of a cognitive model of generalized anxiety disorder (GAD) that has four main components: intolerance of uncertainty, positive beliefs about worry, negative problem orientation, and cognitive avoidance. Although these studies have shown that the model components are associated with high levels of worry in nonclinical samples and with a diagnosis of GAD in clinical samples, they have not addressed the question of whether the model components can predict the severity of GAD. Accordingly, the present study sought to determine if the model components are related to diagnostic severity, worry severity, and somatic symptom severity in a sample of 84 patients with a primary diagnosis of GAD. All model components were related to GAD severity, although positive beliefs about worry and cognitive avoidance were only modestly associated with the severity of the disorder. Intolerance of uncertainty and negative problem orientation had more robust relationships with the severity of GAD (and with worry severity, in particular). When participants were divided into Mild, Moderate, and Severe GAD groups, intolerance of uncertainty and negative problem orientation distinguished the Moderate and Severe GAD groups from the Mild GAD group, even when age, gender, and depressive symptoms were statistically controlled. Overall, the results lend further support to the validity of the model and suggest that intolerance of uncertainty and negative problem orientation are related to the severity of GAD, independently of sociodemographic and associated clinical factors. The theoretical and clinical implications of the findings are discussed. (+info)
CRF type 1 receptors in the dorsal periaqueductal gray modulate anxiety-induced defensive behaviors.
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The dorsal periaqueductal gray (dPAG) is involved in defensive coping reactions to threatening stimuli. Corticotropin releasing factor (CRF) is substantially implicated as a direct modulator of physiological, endocrine and behavioral responses to a stressor. Previous findings demonstrate a direct role of the central CRF system in dPAG-mediated defensive reactions toward a threatening stimulus. These include anxiogenic behaviors in the elevated plus maze (EPM) in rats and defensive reactions in both the mouse defense test battery (MDTB) and rat exposure test (RET) paradigms in mice. Furthermore, CRF was shown to directly and dose-dependently excite PAG neurons in vitro. The aim of the present series of experiments was to directly evaluate the role of the CRF1 receptor (CRF1) in dPAG-induced defensive behaviors in the MDTB and the RET paradigms. For this purpose, cortagine, a novel CRF1-selective agonist, was directly infused into the dPAG. In the RET the high dose of cortagine (100 ng) significantly affected spatial avoidance measures and robustly increased burying behavior, an established avoidance activity, while having no effects on behaviors in the MDTB. Collectively, these results implicate CRF1 in the dPAG as a mediator of temporally and spatially dependent avoidance in response to controllable and constant stimuli. (+info)
Age-related differences in responses to thoughts of one's own death: mortality salience and judgments of moral transgressions.
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Two experiments explored age differences in response to reminders of death. Terror management research has shown that death reminders lead to increased adherence to and defense of one's cultural worldview. In Study 1, the effect of mortality salience (MS) on evaluations of moral transgressions made by younger and older adults was compared. Whereas younger adults showed the typical pattern of harsher judgments in response to MS, older adults did not. Study 2 compared younger and older adults' responses to both the typical MS induction and a more subtle death reminder. Whereas younger adults responded to both MS inductions with harsher evaluations, older adults made significantly less harsh evaluations after the subtle MS induction. Explanations for this developmental shift in responses to reminders of death are discussed. (+info)
When pharmacotherapeutic recommendations may lead to the reverse effect on physician decision-making.
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For long the medical literature has shown that patients do not always receive appropriate care, including pharmacotherapeutic treatment. To achieve improved patient care, a number of physician-oriented interventions are being delivered internationally in an attempt to implement evidence based medicine in routine daily practice of medical practitioners. The pharmacy profession has taken an active role in the delivery of intervention strategies aimed at promoting evidence based prescribing and improved quality and safety of medicine use. However, the medical literature also supports the notion that valid clinical care recommendations do not always have the desired impact on physician behaviour. We argue that the well-established theory of psychological reactance might at least partially explain instances when physicians do not act upon such recommendations. Reactance theory suggests that when recommended to take a certain action, a motivational state compels us to react in a way that affirms our freedom to choose. Often we choose to do the opposite of what the recommendation is proposing that we do or we just become entrenched in our initial position. The basic concepts of psychological reactance are universal and likely to be applicable to the provision of recommendations to physicians. Making recommendations regarding clinical care, including pharmacotherapy, may carry with it implied threats, as it can be perceived as an attempt to restrict one's freedom of choice potentially generating reactance and efforts to avoid them. By identifying and taking into account factors likely to promote reactance, physician-oriented interventions could become more effective. (+info)
Fear of pain and defensive activation.
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Fear of pain and its relationship to dental fear was investigated by measuring autonomic reactions (skin conductance and heart rate) in individuals reporting high and low dental fear when in the presence of a cue that threatened the presentation of electric shock ("threat") or not ("safe"). Acoustic startle probes were also presented during both threat and safe periods, and the reflexive eye blink, the skin conductance response, and cardiac changes to the startle probe measured. All participants reacted with greater defensive reactivity, including potentiated startle blinks, heightened skin conductance, and cardiac deceleration in the context of threat, compared to safe, cues. Individuals reporting high dental fear were significantly more reactive during threat periods, compared to low fear individuals, showing larger blink reflexes and heightened electrodermal activity, as well as heightened autonomic responses to the startle probe itself. Individual differences in defensive reactivity persisted even after participants received a single mild shock halfway through the experiment. The data indicate that threat of shock elicits heightened defensive reactivity in those reporting high dental fear, consistent with the hypothesis that fear of potentially painful events may be a potent mediator of the anxiety involved in anticipated medical and dental treatment. (+info)